U.S. Latino/a adolescents suffer from significantly higher levels of depressive symptoms than Caucasian and African-American adolescents. In 2016, 35% of US Latino/a adolescents reported feeling so sad or hopeless on a daily basis that they were unable to participate in some daily activities (Centers for Disease Control and Prevention [CDC], 2016). When left untreated, these depressive symptoms can lead to a variety of other negative health consequences such as suicidal ideation and attempt (CDC, 2016) and substance use (Cano et al., 2015). In the U.S., Latino/a adolescents experience culturally-based stressors, which are threatening events uniquely experienced by members of a specific ethnic group. These stressors are above and beyond those universal stressors that all U.S. adolescents experience. Many studies have demonstrated that experiencing culturally-based stressors has contributed to the high levels of depressive symptoms in this group, but no study has integrated all of these findings into a cohesive picture of the specific culturally-based stressors that contribute to the development of depressive symptoms for Latino/a adolescents. Bronfenbrenner’s (1994) Ecological Systems Model was used to frame the review by suggesting that the culturally-based stressors that Latino/a adolescents experience may occur on different sociocultural levels within the individual’s environment. The purpose of this review was to identify the specific culturally-based stressors that are associated with the development of depressive symptoms in Latino/a adolescents.
Methods:
Ganong’s (1987) Integrative Review Method was followed in conducting this review. Twenty-nine articles meeting the inclusion criteria were retrieved from CINAHL, PsychINFO, PubMed, and SocINDEX databases from the years 2010-2016. Articles were included in the review if the authors (1) included Latino/a adolescent participants in the sample, (2) measured depressive symptoms, (3) measured a culturally-based stressor, and (4) determined the relationship between the culturally-based stressor and depressive symptoms. Articles were excluded from the analysis if (1) the focus of the study was on pregnant or parenting adolescents or (2) the study was conducted outside the U.S.
Results:
The review revealed that discrimination, family culture conflict, context of reception, immigration stress, intragroup conflict, and acculturative and bicultural stress were culturally-based stressors that were associated with depressive symptoms for Latino/a adolescents. Discrimination was measured in twenty studies (69%) and was defined as unfair, differential treatment based on ethnicity, including negative behaviors such as derogatory remarks, prejudicial treatment, and violence. Family culture conflict was examined in eleven articles (38%) and was defined as disagreement with a family member related to a discrepancy between the cultural values of the family member and adolescent. Three studies (10%) discussed context of reception, which was defined as the perceived degree of openness and opportunity structure in the local community. Three studies (10%) examined immigration stressors, which were measured as the reported difficulties faced when leaving the home country, separation from a primary caregiver, and satisfaction with the decision to move to the U.S. Intragroup conflict occurs when an individual becomes the recipient of negative behaviors or remarks from another person within the same ethnic group and was associated with depressive symptoms in two studies (7%). The concepts of acculturative stress and bicultural were used interchangeably and refer to the stress that results from changing values as a result of coming into contact with another culture and navigating between the heritage culture and the host culture. Acculturative and bicultural stress were associated with depressive symptoms in six studies (21%). These findings should be interpreted in the context of the limitations of the body of literature reviewed, including a lack of consistent conceptual and operational definitions of culturally-based stressors and sampling from a limited number of U.S. states.
Conclusion:
The findings suggest that culturally tailored strategies to treat depressive symptoms in this population need to occur on multiple levels. On a federal and state level, immigration policy changes will affect how Latino/a adolescents experience immigration stressors. These policy changes may also affect the perceived context of reception and discrimination that the adolescent experiences. Strategies to promote unity and racial/ethnic integration in schools may also decrease perceived discrimination and intragroup conflict. Since family culture conflict is a stressor strongly associated with depressive symptoms for Latino/a youth, mental health providers and those individuals working with adolescents should address the adolescents’ experiences of family conflict related to cultural values and involve the family in mental health treatment. Individuals working with U.S. Latino/a adolescents at any level, in healthcare, community, or advocacy settings, should recognize the complexities that Latino/a adolescents face in managing the stressors they experience in family, school, and community settings.